Abstract
We performed an open label single-blind trial with seventeen patients with moderate to severe upper limb spasticity following stroke or traumatic brain injury, treated with an average dose of 165 MU (mouse units) botulinum toxin (range: 100 MU to 210 MU). Evaluation of outcome was carried out analyzing the changes in standard mea sures of impairment, disability, and quality of life. Spasticity reduction, with increased range of motion (ROM), was observed in all patients, independent of the duration of spasticity. Changes either in "focal" or in "global" disability scores occurred in two sub groups of subjects showing, respectively, residual motor function of the extensor mus cles or severe spasticity-related disability. Patients with no residual motricity of the antagonist muscles at the spastic limb, with moderate spasticity, scoring high values on the Functional Independence Measure (FIM) assessment, did not show any disabil ity decrease after treatment. These findings stress the need for an accurate assessment of the patient's impairment and disability to optimize the cost/benefit ratio of BTX appli cation.